<!DOCTYPE html>
<html lang="zh" xmlns:th="http://www.thymeleaf.org" >
<head>
    <th:block th:include="include :: header('随访统计表新增')" />
    <th:block th:include="include :: ztree-css" />
</head>
<body class="white-bg">
<div class="wrapper wrapper-content animated fadeInRight ibox-content">
    <form id="form-SDtpSjdcFollowUpStatistics-add" class="customize-search-form">
        <div class="customize-form-group-container">
            <div class="customize-form-group">
                <label>跟进人:</label>
                <input name="follower" placeholder="跟进人"  id="follower" class="styled-input" type="text">
            </div>
            <div class="customize-form-group">
                <label>年龄:</label>
                <input name="age" placeholder="年龄"  id="age" class="styled-input" type="text">
            </div>
            <div class="customize-form-group">
                <label>性别:</label>
                <input name="gender" placeholder="性别"  id="gender" class="styled-input" type="text">
            </div>
            <div class="customize-form-group">
                <label>适应症:</label>
                <input name="indication" placeholder="适应症"  id="indication" class="styled-input" type="text">
            </div>
            <div class="customize-form-group">
                <label>不良反应:</label>
                <input name="adverseReaction" placeholder="不良反应"  id="adverseReaction" class="styled-input" type="text">
            </div>
            <div class="customize-form-group">
                <label>用药状态:</label>
                <input name="medicationStatus" placeholder="用药状态"  id="medicationStatus" class="styled-input" type="text">
            </div>
            <div class="customize-form-group">
                <label>配合度:</label>
                <input name="cooperationLevel" placeholder="配合度"  id="cooperationLevel" class="styled-input" type="text">
            </div>
            <div class="customize-form-group">
                <label>永久停药:</label>
                <input name="permanentDiscontinuation" placeholder="永久停药"  id="permanentDiscontinuation" class="styled-input" type="text">
            </div>
            <div class="customize-form-group">
                <label>暂停用药:</label>
                <input name="temporarySuspension" placeholder="暂停用药"  id="temporarySuspension" class="styled-input" type="text">
            </div>
            <div class="customize-form-group">
                <label>既往治疗方案:</label>
                <input name="previousTreatmentPlan" placeholder="既往治疗方案"  id="previousTreatmentPlan" class="styled-input" type="text">
            </div>
            <div class="customize-form-group">
                <label>目前治疗方案:</label>
                <input name="currentTreatmentPlan" placeholder="目前治疗方案"  id="currentTreatmentPlan" class="styled-input" type="text">
            </div>
            <div class="customize-form-group">
                <label>生存期（天）:</label>
                <input name="survivalPeriod" placeholder="生存期（天）"  id="survivalPeriod" class="styled-input" type="text">
            </div>
            <div class="customize-form-group">
                <label>药品通用名:</label>
                <input name="genericName" placeholder="药品通用名"  id="genericName" class="styled-input" type="text">
            </div>
            <div class="customize-form-group">
                <label>患者数:</label>
                <input name="patientCount" placeholder="患者数"  id="patientCount" class="styled-input" type="text">
            </div>
            <div class="customize-form-group">
                <label>任务数:</label>
                <input name="taskCount" placeholder="任务数"  id="taskCount" class="styled-input" type="text">
            </div>
        </div>
    </form>
</div>
<th:block th:include="include :: footer" />
<th:block th:include="include :: ztree-js" />
<script type="text/javascript">

    function submitHandler() {
        if ($.validate.form()) {
            add();
        }
    }

    function add() {
        var data = $("#form-SDtpSjdcFollowUpStatistics-add").serializeArray();
        $.ajax({
            cache : true,
            type : "POST",
            url : ctx + "dtp/sdtpsjdcfollowupstatistics/sDtpSjdcFollowUpStatisticsAdd",
            data : data,
            async : false,
            error : function(request) {
                $.modal.alertError("系统错误");
            },
            success : function(data) {
                $.operate.successCallback(data);
            }
        });
    }
</script>
</body>
</html>
